Provider Demographics
NPI:1609195494
Name:GARCIA, ENRIQUE E (MD)
Entity Type:Individual
Prefix:
First Name:ENRIQUE
Middle Name:E
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DICKEL RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-2117
Mailing Address - Country:US
Mailing Address - Phone:914-725-9892
Mailing Address - Fax:
Practice Address - Street 1:90 PARK AVE
Practice Address - Street 2:ROOM 578
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1301
Practice Address - Country:US
Practice Address - Phone:212-551-4019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194953207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine